NURS-FPX4030 PICO (T) Questions and an Evidence-Based Approach

PICO (T) Questions and an Evidence-Based Approach

Creating individualized treatment plans for patients is a crucial part of modern healthcare since it helps providers better meet their patients’ changing needs and expectations. The PICO (T) research approach might be very helpful in this respect. As part of this evaluation, the nurse will determine if COVID-19 positive patients are being improperly positioned in the clinic. The nurse will use the PICO (T) framework, locate data that addresses the study’s hypotheses, and discuss the data’s significance.

Care for Patients Receiving Mechanical Ventilation Using the PICO (T) Framework

In particular, COVID-19 patients have been identified as having acute respiratory failure that need special attention from healthcare providers. The PICOT question is: Is there a difference in fatality rates between individuals with COVID-19 and those who don’t utilize prone posture while receiving therapy when they have acute respiratory failure? Patients with acute respiratory failure who test positive for COVID-19 make up the group under study. Patients who need modest to moderate amounts of additional oxygen will be included in the research. The use of prone posture will be evaluated using reliable sources that can back up their claims. The mortality rate of patients who did not employ prone positioning will be compared to the addition of prone posture to therapy. On the basis of the study’s findings and their applicability in clinical practice, the outcome will be assessed. Finding out whether prone posture reduced COVID-19 patients’ death rates is the goal.

Sources of Evidence

Recovering chances from common and rare causes will be assessed in individuals with COVID-19-induced acute respiratory failure. Sources that combined controlled trials with the clinical context will provide the most convincing findings. Journal papers and peer-reviewed publications that have been evaluated based on clinical trials and analyses of events are examples of the kind of scholarly sources that will be used. While looking for solutions to the PICO (T) questions, it is found here. The CRAAP Test will serve as a guide for evaluating research papers for quality and usefulness. A scholarly research conducted in 2020 serves as the first piece of evidence. In this report, published by respected medical journals, world-renowned researchers analyze the long-term effects of COVID-19 on individuals with acute respiratory failure at the outbreak’s onset. Perspective on patient outcomes before to the use of methods like prone posture is provided in this article. The 2020 peer-reviewed Journal of Clinical Anesthesia publication is the second data source. This article examines the short-term effects of prone posture as part of the treatment strategy for COVID-19-related acute respiration failure. These sources include evidence that could be used to respond to the PICO (T) inquiry.

Analysis of the Results

A study that was carried out on a group of 1,099 hospitalized patients who had acute respiratory failure caused by COVID-19. There is currently no cure for COVID-19, thus therapy focuses on keeping the patient’s lungs functioning normally. Noninvasive ventilation, CPAP treatment, and nasal cannula oxygenation were among the oxygenation therapies used in this study’s patients (NIV). Results are based on non-prone posture since prone positioning was not taken into account at this time. According to the data presented in this article, 19% of patients were hospitalized in critical condition. Nineteen percent of initially mild cases progressed to severe cases, fifteen percent of patients needed NIV, thirty-eight percent of patients required intubation, and eight percent of patients died (Czajkowska-Malinowska et al., 2020).

Prone posture was an integral part of each of the 50 COVID-19-positive patients with acute respiratory failure patients’ treatment plans in the study by Taboada et al. (2020). All of the patients in this trial had acute respiratory failure and were receiving oxygen treatment, although they did not initially need mechanical ventilation. Patients in this trial lay face down for 30–60 minutes at a time, three times daily. Patients’ oxygen saturation was monitored both while they were prone and afterwards. Eighty percent of patients had enhanced SP02 and decreased oxygen requirement. According to this study’s findings, 82% of patients were successfully released home, 14% required intensive care unit treatment, and just 2 patients (4%) died (Taboada et al., 2020).

Relevance of Findings

The outcomes of COVID-19 positive individuals who had acute respiratory failure were evaluated in both papers. These patients served as the scientific foundation for both papers. These patients stand in for the letter “P” in the PICO (T) query. The prone positional intervention served as the “I” in our PICO (T) inquiry. Prone posture was effectively included into the treatment of 50 patients in the study that was published in the Journal of Clinical Anesthesia, with the expected results. Only 4% of patients died, and many of the patients’ oxygenation condition improved. Conclusions In COVID-19 patients suffering from acute respiratory failure, prone posture enhanced outcomes for patients and total oxygen saturation, and reduced the requirement for intensive care unit (ICU) treatment (Taboada et al., 2020). The “C” in our PICO (T) question compared the results of patients whose treatment plans did not include prone posture. According to the report, 38% of the patients needed mechanical breathing, and 8% of them passed away. The conclusion of our PICO (T) query is reached after we evaluate and analyze the data presented by these sites. Research has indicated that patients with COVID-19 who are experiencing acute respiratory failure and are placed in a prone position have a lower death rate than those who are not. There is enough data to justify the use of prone posture to enhance patient outcomes, despite the fact that therapies for COVID-19 are still under investigation and development. Prone positioning has been shown to be effective for individuals with acute respiratory failure due to COVID-19. Some of these outcomes include increased ventilation of the lung region, better matching of ventilation and profusion, and reduced mortality (Penn medicine, 2020).

Conclusion

To sum up, the articles allowed for a comparison to be made between one another in the context of evaluating the COVID-19 treatment. The data presented in the publications is enough to give a satisfying solution to the PICO(T) problem. Studies show that oxygenation in COVID-19 patients with acute respiratory failure is improved when they are placed in the prone position, which also leads to improved outcomes and reduces the risk of mortality.

References

Czajkowska-Malinowska, M., Kania, A., Kuca, P. J., Nasiłowski, J., Skoczyński, S., Sokołowski, R., & Śliwiński, P. S. (2020). Treatment of acute respiratory failure in the course of COVID-19. practical hints from the expert panel of the assembly of intensive care and rehabilitation of the polish respiratory society. Advances in Respiratory Medicine, 88(3),
245. doi:http://dx.doi.org.library.capella.edu/10.5603/ARM.2020.0109
Penn Medicine. Proning during covid-19. (2020) from https://www.pennmedicine.org/updates/blogs/penn-physician-blog/2020/may/proning- during-covid19
Taboada, M., Rodriguez, N. R., Riveiro, V., Abelleira, R., Ricoy, J., Lama, A., . . . Alvarez, J. (2020). Short-term outcomes of 50 patients with acute respiratory distress by COVID-19 where prone positioning was used outside the ICU. Journal of Clinical
Anesthesia, 67 doi:http://dx.doi.org.library.capella.edu/10.1016/j.jclinane.2020.110028
Tove, F. F., Michael Friberg, B. N., Lindhardt, C. L., & Mette, B. E. (2020). Using the full PICO model as a search tool for systematic reviews resulted in lower recall for some PICO elements. Journal of Clinical Epidemiology, 127, 69-75. doi:http://dx.doi.org.library.capella.edu/10.1016/j.jclinepi.2020.07.005